Changes in the electromyographic activity of masticatory muscles in patients undergoing bimaxillary surgery
DOI:
https://doi.org/10.2340/aos.v84.43408Keywords:
Masticatory muscles, electromyography, orthognathic surgery, muscle contractionAbstract
Objective: The aim of this study is to investigate short-term changes in the electromyographic (EMG) activity of masticatory muscles in individuals with skeletal Class III malocclusion undergo double-jaw orthognathic surgery.
Material and methods: In patients with skeletal Class III anomaly, EMG activity changes in the anterior temporalis and masseter muscles were measured before T0 and at 3 (T1) and 6 (T2) months after bimaxillary orthognathic surgery. Recordings were obtained using the ‘MP100’ device and circular Ag-AgCl electrodes during closure, clenching, chewing and swallowing. Data from 26 individuals (12 males, 14 females) with a mean age of 21.7 years were analysed using the Friedman test.
Results: A significant decrease was observed in the right/left masseter muscles during clenching/chewing from T1 to T0 (right and left masseter clenching: p < 0.001, left masseter chewing: p < 0.01, right masseter chewing: p < 0.05), while a significant increase was noted in the right masseter’s clenching function from T2 to T1 (p < 0.01). The EMG activity of the right anterior temporal muscle decreased during clenching at T1–T0 (p < 0.001), increased at T2–T1 (p < 0.05), and decreased during chewing/swallowing at T1–T0 (chewing: p < 0.001, swallowing: p < 0.05) and T2–T0 (p < 0.05). The left anterior temporal muscle showed decreased EMG activity during clenching at T1–T0 (p < 0.001), increased at T2–T1 (p < 0.05), and decreased during chewing at T1–T0 (p < 0.001). During swallowing, a decrease was observed at T2–T0 (p < 0.001).
Conclusions: Partial changes in EMG activity were observed during some functions in the 3-month period; however, no significant overall change was recorded in the 6-month period.
Downloads
References
Sanborn RT. Differences between the facial skeletal patterns of Class III malocclusion and normal occlusion. Angle Orthodontist. 1955;25(4):208–22.
Proffit WR, White RP, Sarver DM. Contemporary treatment of dentofacial deformity. St. Louis (MO): Mosby; 2003.
Graber TM. The “three M’s”: muscles, malformation, and malocclusion. Am J Orthod. 1963;49(6):418–50. https://doi.org/10.1016/0002-9416(63)90167-2 DOI: https://doi.org/10.1016/0002-9416(63)90167-2
Virji SA, Ng ET, Jayachandran S, Heit TC. A case study on myofunctional therapy and malocclusions created by oral habits. Can J Dent Hyg. 2023;57(1):61.
Okeson J. Management of temporomandibular disorders and occlusion. 8 ed. St. Louis: Elsevier; 2020.
Drake R, Vogl, AW, & Mitchell, AWM. Gray’s basic anatomy. 3 ed. Philadelphia: Elsevier; 2023.
Fehrenbach M, & Herring, SW. . Illustrated Anatomy of the Head and Neck-E-Book. 5th ed. St. Louis: Elsevier; 2017.
Basmajian J. Muscles alive. Their functions revealed by electromyography. 2 ed. Baltimore: The Williams & Wilkins Company; 1967.
Barrett K, Barman S, Brooks, HL., & Yuan, J. Ganong’s Review of Medical Physiology. 26 ed. New York: McGraw-Hill Education; 2019.
Michell A. Understanding EMG. Oxford: OUP Oxford; 2013. DOI: https://doi.org/10.1093/med/9780199595501.001.0001
Di Palma E, Tepedino M, Chimenti C, Tartaglia GM, Sforza C. Effects of the functional orthopaedic therapy on masticatory muscles activity. J Clin Exp Dent. 2017;9(7):e886. https://doi.org/10.4317/jced.53986 DOI: https://doi.org/10.4317/jced.53986
Kiliç N. Investigation of the changes in dentofacial structures and chewing muscle tonicity induced by semi-rapid and rapid maxillary expansion [dissertation]. Erzurum: Atatürk University; 2005.
Pumklin J, Sowithayasakul T, Thaweemonkongsap C, Saptasevee P, Sangprasert P. Effects of occlusal conditions on masseter and temporalis muscle activity: an electromyographic evaluation. Saudi Dent J. 2023;35(8):946–52. https://doi.org/10.1016/j.sdentj.2023.07.018 DOI: https://doi.org/10.1016/j.sdentj.2023.07.018
Woźniak K, Piątkowska D, Lipski M, Mehr K. Surface electromyography in orthodontics – a literature review. Med Sci Monit Int Med J Exp Clin Res. 2013;19:416. https://doi.org/10.12659/MSM.883927 DOI: https://doi.org/10.12659/MSM.883927
Ingervall B, Thüer U. Temporal muscle activity during the first year of Class II, division 1 malocclusion treatment with an activator. Am J Orthod Dentofac Orthoped. 1991;99(4):361–8. https://doi.org/10.1016/0889-5406(91)70019-S DOI: https://doi.org/10.1016/0889-5406(91)70019-S
Alshammari A, Almotairy N, Kumar A, Grigoriadis A. Effect of malocclusion on jaw motor function and chewing in children: a systematic review. Clin Oral Investig. 2022;26(3):2335–51. https://doi.org/10.1007/s00784-021-04356-y DOI: https://doi.org/10.1007/s00784-021-04356-y
Svitlana Y, Sergii T, Yuriі Y, Komlev A. Application of electromyography method for diagnosis and treatment of stomatology diseases. Eur J Biomed Life Sci. 2021(3):9–14. https://doi.org/10.29013/ELBLS-21-3-9-14 DOI: https://doi.org/10.29013/ELBLS-21-3-9-14
Zhan Y, Yang M, Bai S, Zhang S, Huang Y, Gong F, et al. Effects of orthodontic treatment on masticatory muscles activity: a meta-analysis. Ann Hum Biol. 2023;50(1):465–71. https://doi.org/10.1080/03014460.2023.2271840 DOI: https://doi.org/10.1080/03014460.2023.2271840
Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Cernera M, Esposito L, Woźniak K, Spagnuolo G. Electromyographic assessment of muscle activity in children undergoing orthodontic treatment – a systematic review. J Clin Med. 2024;13(7):2051. https://doi.org/10.3390/jcm13072051 DOI: https://doi.org/10.3390/jcm13072051
Di Palma E, Gasparini G, Pelo S, Tartaglia GM, Chimenti C. Activities of masticatory muscles in patients after orthognathic surgery. J Cranio-Maxillofac Surg. 2009;37(7):417–20. https://doi.org/10.1016/j.jcms.2009.05.004 DOI: https://doi.org/10.1016/j.jcms.2009.05.004
Çelakıl D, Özdemir F, Eraydın F, Çelakıl T. Effect of orthognathic surgery on masticatory performance and muscle activity in skeletal Class III patients. CRANIO®. 2017;36(3):174–80. https://doi.org/10.1080/08869634.2017.1311395 DOI: https://doi.org/10.1080/08869634.2017.1311395
Frongia G, Ramieri G, De Biase C, Bracco P, Piancino MG. Changes in electric activity of masseter and anterior temporalis muscles before and after orthognathic surgery in skeletal class III patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(4):398–401. https://doi.org/10.1016/j.oooo.2013.06.008 DOI: https://doi.org/10.1016/j.oooo.2013.06.008
Ko EW-C, Huang CS, Lo L-J, Chen Y-R. Alteration of masticatory electromyographic activity and stability of orthognathic surgery in patients with skeletal class III malocclusion. J Oral Maxillofac Surg. 2013;71(7):1249–60. https://doi.org/10.1016/j.joms.2013.01.002 DOI: https://doi.org/10.1016/j.joms.2013.01.002
Kobayashi T, Honma K, Shingaki S, Nakajima T. Changes in masticatory function after orthognathic treatment in patients with mandibular prognathism. Br J Oral Maxillofac Surg. 2001;39(4):260–5. https://doi.org/10.1054/bjom.2000.0576 DOI: https://doi.org/10.1054/bjom.2000.0576
Nakata Y, Ueda HM, Kato M, Tabe H, Shikata-Wakisaka N, Matsumoto E, et al. Changes in stomatognathic function induced by orthognathic surgery in patients with mandibular prognathism. J Oral Maxillofac Surg. 2007;65(3):444–51. https://doi.org/10.1016/j.joms.2005.12.071 DOI: https://doi.org/10.1016/j.joms.2005.12.071
Nishi SE, Basri R, Alam MK, Komatsu S, Komori A, Sugita Y, et al. Evaluation of masticatory muscles function in different malocclusion cases using surface electromyography. J Hard Tissue Biol. 2017;26(1):23–8. https://doi.org/10.2485/jhtb.26.23 DOI: https://doi.org/10.2485/jhtb.26.23
Trawitzki LVV, Dantas RO, Mello-Filho FV, Marques Jr W. Effect of treatment of dentofacial deformities on the electromyographic activity of masticatory muscles. Int J Oral Maxillofac Surg. 2006;35(2):170–3. https://doi.org/10.1016/j.ijom.2005.07.008 DOI: https://doi.org/10.1016/j.ijom.2005.07.008
Gomes SF, Custodio W, Faot F, Del Bel Cury A, Garcia RR. Masticatory features, EMG activity and muscle effort of subjects with different facial patterns. J Oral Rehabil. 2010;37(11):813–9. https://doi.org/10.1111/j.1365-2842.2010.02075.x DOI: https://doi.org/10.1111/j.1365-2842.2010.02075.x
Muftuoglu O, Akturk ES, Eren H, Gorurgoz C, Karasu HA, Orhan K, et al. Long-term evaluation of masseter muscle activity, dimensions, and elasticity after orthognathic surgery in skeletal class III patients. Clin Oral Investig. 2023;27(7):3855–61. https://doi.org/10.1007/s00784-023-05004-3 DOI: https://doi.org/10.1007/s00784-023-05004-3
Raustia AM, Oikarinen KS. Changes in electric activity of masseter and temporal muscles after mandibular sagittal split osteotomy. Int J Oral Maxillofac Surg. 1994;23(3):180–4. https://doi.org/10.1016/S0901-5027(05)80297-8 DOI: https://doi.org/10.1016/S0901-5027(05)80297-8
Kawai N, Shibata M, Watanabe M, Horiuchi S, Fushima K, Tanaka E. Effects of functional training after orthognathic surgery on masticatory function in patients with mandibular prognathism. J Dent Sci. 2020;15(4):419–25. https://doi.org/10.1016/j.jds.2020.01.006 DOI: https://doi.org/10.1016/j.jds.2020.01.006
Kim K-A, Park H-S, Lee S-Y, Kim S-J, Baek S-H, Ahn H-W. Short-term changes in muscle activity and jaw movement patterns after orthognathic surgery in skeletal Class III patients with facial asymmetry. Korean J Orthod. 2019;49(4):254–64. https://doi.org/10.4041/kjod.2019.49.4.254 DOI: https://doi.org/10.4041/kjod.2019.49.4.254
Ingervall B, Ridell A, Thilander B. Changes in activity of the temporal, masseter and lip muscles after surgical correction of mandibular prognathism. Int J Oral Surg. 1979;8(4):290–300. https://doi.org/10.1016/S0300-9785(79)80051-4 DOI: https://doi.org/10.1016/S0300-9785(79)80051-4
Farronato G, Giannini L, Galbiati G, Sesso G, Maspero C. Orthodontic-surgical treatment: neuromuscular evaluation in skeletal Class II and Class III patients. Progr Orthod. 2012;13(3):226–36. https://doi.org/10.1016/j.pio.2012.04.003 DOI: https://doi.org/10.1016/j.pio.2012.04.003
Akturk ES, Eren H, Gorurgoz C, Orhan K, Karasu HA, Akat B, et al. Electromyographic, ultrasonographic, and ultrasound elastographic evaluation of the masseter muscle in class III patients before and after orthognathic surgery. J Craniofac Surg. 2020;31(7):2049–53. https://doi.org/10.1097/SCS.0000000000006589 DOI: https://doi.org/10.1097/SCS.0000000000006589
Castroflorio T, Farina D, Bottin A, Piancino MG, Bracco P, Merletti R. Surface EMG of jaw elevator muscles: effect of electrode location and inter‐electrode distance. J Oral Rehabil. 2005;32(6):411–7. https://doi.org/10.1111/j.1365-2842.2005.01442.x DOI: https://doi.org/10.1111/j.1365-2842.2005.01442.x
Olivares HG, Pérez AG, Saucedo FL, Medina FÁ. Electromyographic changes in the masseter and temporalis muscles before and after orthognathic surgery in patients with mandibular prognathism. J Craniofac Surg. 2019;30(5):1539–43. https://doi.org/10.1097/SCS.0000000000005395 DOI: https://doi.org/10.1097/SCS.0000000000005395
Ferrario V, Sforza C, D’addona A, Miani Jr A. Reproducibility of electromyographic measures: a statistical analysis. J Oral Rehabil. 1991;18(6):513–21.https://doi.org/10.1111/j.1365-2842.1991.tb00074.x DOI: https://doi.org/10.1111/j.1365-2842.1991.tb00074.x
Ingervall B. Activity of temporal and lip muscles during swallowing and chewing. J Oral Rehabil. 1978;5(4):329–37. https://doi.org/10.1111/j.1365-2842.1978.tb01251.x DOI: https://doi.org/10.1111/j.1365-2842.1978.tb01251.x
Cha BK, Kim C-H, Baek S-H. Skeletal sagittal and vertical facial types and electromyographic activity of the masticatory muscle. Angle Orthod. 2007;77(3):463–70. https://doi.org/10.2319/0003-3219(2007)077[0463:SSAVFT]2.0.CO;2 DOI: https://doi.org/10.2319/0003-3219(2007)077[0463:SSAVFT]2.0.CO;2
Ciccone de Faria TS, Hallak Regalo SC, Thomazinho A, Vitti M, De Felício CM. Masticatory muscle activity in children with a skeletal or dentoalveolar open bite. Eur J Orthod. 2010;32(4):453–8. https://doi.org/10.1093/ejo/cjp132 DOI: https://doi.org/10.1093/ejo/cjp132
Miralles R, Hevia R, Contreras L, Carvajal R, Bull R, Manns A. Patterns of electromyographic activity in subjects with different skeletal facial types. Angle Orthod. 1991;61(4):277–84.
Moreno I, Sanchez T, Ardizone I, Aneiros F, Celemin A. Electromyographic comparisons between clenching, swallowing and chewing in jaw muscles with varying occlusal parameters. Medicina Oral Patologia Oral Y Cirugia Bucal. 2008;13(3):207.
Yousefzadeh F, Shcherbatyy V, King GJ, Huang GJ, Liu Z-J. Cephalometric and electromyographic study of patients of East African ethnicity with and without anterior open bite. Am J Orthod Dentofac Orthoped. 2010;137(2):236–46. https://doi.org/10.1016/j.ajodo.2008.03.033 DOI: https://doi.org/10.1016/j.ajodo.2008.03.033
Ahlgren JG, Ingervall BF, Thilander BL. Muscle activity in normal and postnormal occlusion. Am J Orthod. 1973;64(5):445–56. https://doi.org/10.1016/0002-9416(73)90258-3 DOI: https://doi.org/10.1016/0002-9416(73)90258-3
Duarte F, Silva JN, Hopper C, Hunt N. Masseter muscle adaptation following orthognathic surgery-MRI analysis. Sci Arch Dent Sci. 2020;3(7):11–9.
Eo PS, Park TH, Ryu JY, Lee JS, Yang JD, Chung HY, et al. The effect of orthognathic surgery on changes in masticatory muscle volume in patients with facial asymmetry. J Craniofac Surg. 2022;33(5):1288–93. https://doi.org/10.1097/SCS.0000000000008322 DOI: https://doi.org/10.1097/SCS.0000000000008322
Lee D-H, Yu H-S. Masseter muscle changes following orthognathic surgery: a long-term three-dimensional computed tomography follow-up. Angle Orthod. 2012;82(5):792–8. https://doi.org/10.2319/111911-717.1 DOI: https://doi.org/10.2319/111911-717.1
Ohkura K, Harada K, Morishima S, Enomoto S. Changes in bite force and occlusal contact area after orthognathic surgery for correction of mandibular prognathism. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2001;91(2):141–5. https://doi.org/10.1067/moe.2001.112334 DOI: https://doi.org/10.1067/moe.2001.112334
Widmalm SE, Lee Y-S, McKay DC. Clinical use of qualitative electromyography in the evaluation of jaw muscle function: a practitioner’s guide. CRANIO®. 2007;25(1):63–73. https://doi.org/10.1179/crn.2007.011 DOI: https://doi.org/10.1179/crn.2007.011
Panichsiti N, Wattanachai T, Suzuki B. Masseter and temporalis muscle activity in patients with class III skeletal relationships. Chiang Mai Dent J [Internet]. 2018;39(2):57–67. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=119
Sforza C, Peretta R, Grandi G, Ferronato G, Ferrario VF. Soft tissue facial planes and masticatory muscle function in skeletal Class III patients before and after orthognathic surgery treatment. J Oral Maxillofac Surg. 2008;66(4):691–8. https://doi.org/10.1016/j.joms.2007.06.645 DOI: https://doi.org/10.1016/j.joms.2007.06.645
Trawitzki LVV, Dantas RO, Mello-Filho FV, Marques Jr W. Masticatory muscle function three years after surgical correction of class III dentofacial deformity. Int J Oral Maxillofac Surg. 2010;39(9):853–6. https://doi.org/10.1016/j.ijom.2009.03.006 DOI: https://doi.org/10.1016/j.ijom.2009.03.006
Ferrario VF, Sforza C. Coordinated electromyographic activity of the human masseter and temporalis anterior muscles during mastication. Eur J Oral Sci. 1996;104(5‐6):511–7. https://doi.org/10.1111/j.1600-0722.1996.tb00134.x DOI: https://doi.org/10.1111/j.1600-0722.1996.tb00134.x
Published
Issue
Section
License
Copyright (c) 2025 Ali Kağan Özen , İsmail Ceylan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
